Comparison of recidivism rates for a teenage trauma prevention program after the addition of high-fidelity patient simulation

Objectives: We evaluated the benefits of adding high-fidelity simulation to a teenage trauma prevention program to decrease recidivism rates and encourage teens to discuss actionable steps toward safe driving.

Methods: A simulated pediatric trauma scenario was integrated into an established trauma prevention program. Participants were recruited because they were court-ordered to attend this program after misdemeanor convictions for moving violations. The teenage participants viewed this simulation from the emergency medical services (EMS) handoff to complete trauma care. Participants completed a postsimulation knowledge assessment and care evaluation, which included narrative data about the experience. Qualitative analysis of color-coded responses identified common themes and experiences in participants' answers. Court records were reviewed 6 years after course completion to determine short- and long-term recidivism rates, which were then compared to our program's historical rate.

Results: One hundred twenty-four students aged 16–20 years participated over a 2-year study period. Narrative responses included general reflection, impressions, and thoughts about what they might change as a result of the course. Participants reported that they would decrease speed (30%), wear seat belts (15%), decrease cell phone use (11%), and increase caution (28%). The recidivism rate was 55% within 6 years. At 6 months it was 8.4%, at 1 year it was 20%, and it increased approximately 5–8% per year after the first year. Compared with our programs, for historical 6-month and 2-year recidivism rates, no significant difference was seen with or without simulation.

Conclusions: Adding simulation is well received by participants and leads to positive reflections regarding changes in risk-taking behaviors but resulted in no changes to the high recidivism rates This may be due to the often ineffectiveness of fear appeals.     

Indirect effects of a key ecosystem engineer alter survival and growth of foundation coral species

Stegastes nigricans, a "farmerfish" that cultivates algal turf and defends territories from grazers and other intruders, can affect coral indirectly due to increased competition with farmed algal turf and/or reduced predation resulting from territorial aggression directed at corallivores. To investigate the indirect effects of this key ecosystem engineer on coral mortality and growth, we transplanted caged and exposed fragments of four coral species to patch reefs in French Polynesia on which we manipulated the presence of S. nigricans and turf, and to reefs naturally devoid of S. nigricans. Reef access was two to four times higher for herbivorous fishes, and two times higher for corallivorous fishes, when S. nigricans was removed, indicating that reef access is reduced for two important guilds of fishes when S. nigricans is present. Stegastes' territoriality indirectly benefited delicate acroporids (Montipora floweri and Acropora striata), yielding a twofold to fivefold reduction in skeletal loss due to lower predation frequencies in the presence of S. nigricans. Three corals, A. striata, M. floweri, and especially Porites australiensis, suffered mortality due to overgrowth significantly more frequently in the presence of farmed turf, but Pocillopora verrucosa did not. Algal abundance predicted the frequency of overgrowth for only A. striata and P. australiensis. M. floweri were more likely to be overgrown when exposed (uncaged) in the presence of S. nigricans, suggesting an interaction modification, in this case that initial predation increased susceptibility to competition with turf. In this community, the presence of S. nigricans may increase algal overgrowth of massive Porites by facilitating its turf competitors and simultaneously reduce predation of branching corals through territorial exclusion of corallivores. These indirect interactions may underlie previously documented community transitions from disturbance-resistant massive coral to recovering branching corals within S. nigricans territories.     

Applying Principles of Landscape Design and Management to Integrate Old-Growth Forest Enhancement and Commodity Use

Using geographic information systems (GIS) and spatial analysis techniques, we developed a landscape design to maintain old-growth forest remnants and integrate commodity production in the surrounding second-growth matrix. The 4500-ha forest landscape in northern Wisconsin contains scattered patches of old-growth eastern hemlock ( Tsuga canadensis ) and northern hardwoods, predominately sugar maple ( Acer saccharum ). The design incorporates an old-growth restoration zone surrounding old-growth patches to buffer and enhance forest-interior habitat and link nearby old-growth remnants. This addition restores aspects of landscape patch size and structure and ecosystem juxtaposition that characterize a nearby, large, and contiguous natural old-growth landscape. A larger secondary zone is delineated for uneven-aged forest management. This zone provides a matrix structurally similar to the old-growth patches but also accommodates harvesting. A larger outer zone is retained primarily in even-aged forest of aspen ( Populus tremuloides ) and paper birch ( Betula papyrifera ), but traditional clearcutting practices are modified to partial cutting and mixed-species rotations. This design meets limited goals of biodiversity enhancement and integrated commodity production in a landscape that will remain largely harvested. The landscape design is therefore improved not only by buffers and corridors provided to old-growth ecosystems, but by modifying the management of the majority commodity lands matrix as well.     

A role for selective contraception of individuals in conservation

Contraception has an established role in managing overabundant populations and preventing undesirable breeding in zoos. We propose that it can also be used strategically and selectively in conservation to increase the genetic and behavioral quality of the animals. In captive breeding programs, it is becoming increasingly important to maximize the retention of genetic diversity by managing the reproductive contribution of each individual and preventing genetically suboptimal breeding through the use of selective contraception. Reproductive suppression of selected individuals in conservation programs has further benefits of allowing animals to be housed as a group in extensive enclosures without interfering with breeding recommendations, which reduces adaptation to captivity and facilitates the expression of wild behaviors and social structures. Before selective contraception can be incorporated into a breeding program, the most suitable method of fertility control must be selected, and this can be influenced by factors such as species life history, age, ease of treatment, potential for reversibility, and desired management outcome for the individual or population. Contraception should then be implemented in the population following a step‐by‐step process. In this way, it can provide crucial, flexible control over breeding to promote the physical and genetic health and sustainability of a conservation dependent species held in captivity. For Tasmanian devils (Sarcophilus harrisii), black‐flanked rock wallabies (Petrogale lateralis), and burrowing bettongs (Bettongia lesueur), contraception can benefit their conservation by maximizing genetic diversity and behavioral integrity in the captive breeding program, or, in the case of the wallabies and bettongs, by reducing populations to a sustainable size when they become locally overabundant. In these examples, contraceptive duration relative to reproductive life, reversibility, and predictability of the contraceptive agent being used are important to ensure the potential for individuals to reproduce following cessation of contraception, as exemplified by the wallabies when their population crashed and needed females to resume breeding.     

A multi-criteria geographic information systems approach for the measurement of vulnerability to climate change

A flexible procedure for the development of a multi-criteria composite index to measure relative vulnerability under future climate change scenarios is presented. The composite index is developed using the Weighted Ordered Weighted Average (WOWA) aggregation technique which enables the selection of different levels of trade-off, which controls the degree to which indicators are able to average out others. We explore this approach in an illustrative case study of the United States (US), using future projections of widely available indicators quantifying flood vulnerability under two scenarios of climate change. The results are mapped for two future time intervals for each climate scenario, highlighting areas that may exhibit higher future vulnerability to flooding events. Based on a Monte Carlo robustness analysis, we find that the WOWA aggregation technique can provide a more flexible and potentially robust option for the construction of vulnerability indices than traditionally used approaches such as Weighted Linear Combinations (WLC). This information was used to develop a proof-of-concept vulnerability assessment to climate change impacts for the US Army Corps of Engineers. Lessons learned in this study informed the climate change screening analysis currently under way.     

The relationship between adaptation and mitigation in managing climate change risks: a regional response from North Central Victoria,Australia

This two-part paper considers the complementarity between adaptation and mitigation in managing the risks associated with the enhanced greenhouse effect. Part one reviews the application of risk management methods to climate change assessments. Formal investigations of the enhanced greenhouse effect have produced three generations of risk assessment. The first led to the United Nations Intergovernmental Panel on Climate Change (IPCC), First Assessment Report and subsequent drafting of the United Nations Framework Convention on Climate Change. The second investigated the impacts of unmitigated climate change in the Second and Third IPCC Assessment Reports. The third generation, currently underway, is investigating how risk management options can be prioritised and implemented. Mitigation and adaptation have two main areas of complementarity. Firstly, they each manage different components of future climate-related risk. Mitigation reduces the number and magnitude of potential climate hazards, reducing the most severe changes first. Adaptation increases the ability to cope with climate hazards by reducing system sensitivity or by reducing the consequent level of harm. Secondly, they manage risks at different extremes of the potential range of future climate change. Adaptation works best with changes of lesser magnitude at the lower end of the potential range. Where there is sufficient adaptive capacity, adaptation improves the ability of a system to cope with increasingly larger changes over time. By moving from uncontrolled emissions towards stabilisation of greenhouse gases in the atmosphere, mitigation limits the upper part of the range. Different activities have various blends of adaptive and mitigative capacity. In some cases, high sensitivity and low adaptive capacity may lead to large residual climate risks; in other cases, a large adaptive capacity may mean that residual risks are small or non-existent. Mitigative and adaptive capacity do not share the same scale: adaptive capacity is expressed locally, whereas mitigative capacity is different for each activity and location but needs to be aggregated at the global scale to properly assess its potential benefits in reducing climate hazards. This can be seen as a demand for mitigation, which can be exercised at the local scale through exercising mitigative capacity. Part two of the paper deals with the situation where regional bodies aim to maximise the benefits of managing climate risks by integrating adaptation and mitigation measures at their various scales of operation. In north central Victoria, Australia, adaptation and mitigation are being jointly managed by a greenhouse consortium and a catchment management authority. Several related studies investigating large-scale revegetation are used to show how climate change impacts and sequestration measures affect soil, salt and carbon fluxes in the landscape. These studies show that trade-offs between these interactions will have to be carefully managed to maximise their relative benefits. The paper concludes that when managing climate change risks, there are many instances where adaptation and mitigation can be integrated at the operational level. However, significant gaps between our understanding of the benefits of adaptation and mitigation between local and global scales remain. Some of these may be addressed by matching demands for mitigation (for activities and locations where adaptive capacity will be exceeded) with the ability to supply that demand through localised mitigative capacity by means of globally integrated mechanisms.     

Behavioral responses of bison and elk in Yellowstone to snowmobiles and snow coaches.

Managers of public lands are charged with protecting some of our most important natural resources and ecosystems, while providing for their use and enjoyment by visitors. Almost one million visitors entered Yellowstone National Park by motorized means on snowmobiles (87%) or snow coaches (13%) during 1992-2003. Most vehicles toured the central portion of the park where bison (Bison bison) and elk (Cervus elaphus) concentrate in geothermal areas. We sampled >6500 interactions between groups of these species and groups of snowmobiles and snow coaches (collectively, OSV, over-snow vehicles) during five winters (1999-2000, 2002-2004). Multinomial logits models were used to identify conditions leading to behavioral responses. Elk responded three times as often (52%) as bison (19%) during interactions with groups of snowmobiles and snow coaches due to increased vigilance responses (elk, 44%; bison, 10%). However, the frequency of higher-intensity movement responses by bison and elk were similar (6-7% travel, 1-2% flight, <1% defense) and relatively low compared to other studies of ungulates and snowmobile disturbance. The likelihood of active responses by bison and elk increased significantly if animals were on or near roads, groups were smaller, or humans approached. The likelihood of an active response by bison decreased within winters having the largest visitation, suggesting some habituation to snowmobiles and snow coaches. There was no evidence that snowmobile use during the past 35 years affected the population dynamics or demography of bison or elk. Thus, we suggest that regulations restricting levels and travel routes of over-snow vehicles (OSVs) were effective at reducing disturbances to bison and elk below a level that would cause measurable fitness effects. We recommend park managers consider maintaining OSV traffic levels at or below those observed during our study. Regardless, differing interpretations of the behavioral and physiological response data will continue to exist because of the diverse values and beliefs of the many constituencies of Yellowstone.     

Day-of-Week behavior of atmospheric ozone in three U.S. cities

The weekly cycles of atmospheric ozone (O3) are of interest because they provide information about the response of O3 to changes in anthropogenic emissions from weekdays to weekends. The weekly behavior of O3 in Chicago, IL; Philadelphia, PA; and Atlanta, GA, is contrasted. In Chicago and Philadelphia, maximum 1-hr average O3 increases on weekends. In Atlanta, O3 builds up from Mondays to Fridays and declines during weekends. In all three areas, volatile organic compound (VOC)/nitrogen oxides (NOx) ratios are higher during weekends, resulting from greater than proportionate decreases in NOx relative to VOC emissions. The VOC/NOx ratios correlate with maximum 1-hr O3 concentrations in Chicago, a response consistent with a VOC-sensitive airshed. A weak correlation between O3 concentrations and VOC/NOx ratios in Philadelphia suggests the impact of transported O3, which is formed in upwind VOC-sensitive locations that may be hundreds of kilometers away. Ozone concentrations in Atlanta do not correlate with VOC/NOx ratios but with concentrations of NOx and total reactive nitrogen (NOy) carried over from the previous day. When data from 1986-1990 and 1995-1999 are compared, only small differences in the weekly behavior of O3 are observed in Chicago and Philadelphia. The day-of-week differences in O3 are amplified in the more recent period in Atlanta, a possible result of urban growth.     

Effective parameters for two-phase flow in a porous medium with periodic heterogeneities

Computational simulations of two-phase flow in porous media are used to investigate the feasibility of replacing a porous medium containing heterogeneities with an equivalent homogeneous medium. Simulations are performed for the case of infiltration of a dense nonaqueous phase liquid (DNAPL) in a water-saturated, heterogeneous porous medium. For two specific porous media, with periodic and rather simple heterogeneity patterns, the existence of a representative elementary volume (REV) is studied. Upscaled intrinsic permeabilities and upscaled nonlinear constitutive relationships for two-phase flow systems are numerically calculated and the effects of heterogeneities are evaluated. Upscaled capillary pressure-saturation curves for drainage are found to be distinctly different from the lower-scale curves for individual regions of heterogeneity. Irreducible water saturation for the homogenized medium is found to be much larger than the corresponding lower-scale values. Numerical simulations for both heterogeneous and homogeneous representations of the considered porous media are carried out. Although the homogenized model simulates the spreading behavior of DNAPL reasonably well, it still fails to match completely the results form the heterogeneous simulations. This seems to be due, in part, to the nonlinearities inherent to multiphase flow systems. Although we have focussed on a periodic heterogeneous medium in this study, our methodology is applicable to other forms of heterogeneous media. In particular, the procedure for identification of a REV, and associated upscaled constitutive relations, can be used for randomly heterogeneous or layered media as well.